Dr. David B. Adams – Psychological Blog

Psychology of Injury, Pain, Anxiety and Depression

Interpreting Pain

Injured workers have difficulty coping with their pain because they believe that it:a. stops them from engaging in any pleasant or rewarding activitiesb. makes them feel helpless to change the situation in which they find themselvesc. dictates their life until it is gone

The goals of treating the pain patient are to:1. make certain that patients are aware of negative beliefs regarding their skills and abilities2. help the patient manage pain by awareness of the thoughts and emotions that potentiate and maintain stress and physical symptoms3. guide the patient toward productive thoughts, beliefs, expectations, and predictions to combat the negative expectations which they harbor4. insure that the patient resets his/her goals: a. establishes new ways to achieve targets, b. manages difficult times, and c. practices coping skills including regulating arousal levels despite fluctuations of pain

Patients must be taught how to challege counterproductive assumptions and beliefs about their pain; to learn more effective problem solving and, thereby, achieve confidence by mastering these new pain management skills.

The progression is as follows:A. The patient is shown how their thoughts, emotions and behaviors directly impact their experience of painB. The patient is shown how their expectancies of increased pain arise from their own responses to the pain C. The patient is taught effective problem solving methods; permitting them to analyze each situation and develop coping strategies plans for time of acute exacerbation of painD. The patient gains an understanding of how to cope with social and home situations in which they believe the pain to be an unmanageable encumbrance.

For chronic pain patients, this approach permits them to manage pain with less catastrophic thinking and expectancies of global failure.